S536
Clinical – Head & neck
ESTRO 2026
Conclusion: SHEDPC carries a poor prognosis. The addition of PD-1 blockade to chemoradiotherapy is associated with substantial and clinically meaningful improvements in long-term survival and locoregional control without introducing additional severe toxicity. Our data provide a strong real-world rationale for conducting prospective randomized trials to establish the combination of CRT plus ICIs as the new standard of care (SOC) for this challenging patient population. Keywords: Hypopharyngeal-Esophageal Dual Primary Cancer Digital Poster 379 Adult versus pediatric nasopharyngeal carcinoma: two clinical entities or one continuum Nasim Sarhan 1 , Hamzah Ghatasheh 1 , Issa Mohamad 1 , Mohammad Berawi 1 , Abdulla Alzibdeh 1 , Ahmad KH. Ibrahimi 1 , Taher Abu Hejleh 2 , Hadeel Halalsheh 3 , Iyad Sultan 3 , Taleb Ismael 3 , Khalil Abd Al-Hadi 4 , Ayat Taqash 5 , Maha Barbar 3 , Maysa AL-Hussaini 6 , Abdelatif Almousa 1 , Ali Hosni 7 1 Radiation Oncology, King Hussein Cancer Center, Amman, Jordan. 2 Medical Oncology, King Hussein Cancer Center, Amman, Jordan. 3 Pediatric Oncology, King Hussein Cancer Center, Amman, Jordan. 4 Nursing Department, King Hussein Cancer Center, Amman, Jordan. 5 Biostatistics, King Hussein Cancer Center, Amman, Jordan. 6 Cell Therapy and Applied Genomics, King Hussein Cancer Center, Amman, Jordan. 7 Radiation Oncology, Princess Margaret Cancer Centre / University of Toronto, Toronto, Canada Purpose/Objective: Nasopharyngeal carcinoma (NPC) is rare in children and presents distinct biological and clinical features compared to adults. Comparative outcome data remain limited, particularly regarding patterns of failure. Material/Methods: We retrospectively analyzed 164 patients with non- metastatic NPC treated at our institution from 2002– 2023. Patients ≤ 18 years were classified as pediatric and >18 years as adult (n=106). All received curative- intent radiotherapy with chemotherapy as per standard protocols. Survival outcomes and failure patterns were compared. Results: A total of 164 NPC patients were included (106 adult and 58 pediatric). Compared to adult NPC, pediatric patients with NPC had more frequent undifferentiated non-keratinizing carcinoma histologic subtype (100% vs 88.7%, p<0.01), more EBV-associated disease (51.7% vs 37.2%, p<0.01), and more advanced (cN2-3) nodal category (75.9% vs 59.4%, p=0.001). With a medial
Digital Poster 367
Immunotherapy Improves Survival in Synchronous Hypopharyngeal-Esophageal Dual Primary Cancer (SHEDPC) with Chemoradiotherapy: An Observational Study JIANCHAO LU, SHICHUAN ZHANG, Qifeng Wang Radiation Oncology, Sichuan Cancer Hospital, Chengdu, China Purpose/Objective: Synchronous Hypopharyngeal-Esophageal Dual Primary Cancer (SHEDPC) presents a significant clinical challenge with inherently poor prognosis and limited treatment tolerance due to the extensive treatment field. The role of adding immune checkpoint inhibitors (ICIs) to chemoradiotherapy (CRT) for this aggressive dual cancer remains undefined. This study aims to evaluate the efficacy of ICIs and identify independent prognostic factors in patients with SHEDPC. Material/Methods: We retrospectively analyzed 75 patients with confirmed SHEDPC who received CRT at our center between October 2010 and October 2024. Patients were stratified into an ICIs group (receiving CRT + ICIs) and a non-ICIs group (receiving CRT alone). Survival endpoints, including overall survival (OS), disease-free survival (DFS), locoregional recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS), were estimated using the Kaplan-Meier method. Univariable and multivariable Cox proportional hazards models identified independent prognostic factors for OS. Results: The median follow-up was 47.0 months for the Non- ICIs group and 28.0 months for the ICIs group. The median OS for the entire cohort was 24 months, with a 3-year OS rate of 29.9%.The addition of ICIs significantly improved long-term survival and locoregional control:Overall Survival (OS): The 1- and 3-year OS rates were significantly higher in the ICIs group (78.8% and 50.7%) compared to the non-ICIs group (66.7% and 21.4%; P=0.008).Locoregional Recurrence-Free Survival (LRFS): The 1- and 3-year LRFS rates were also significantly higher in the ICIs group (69.7% and 39.7%) compared to the non-ICIs group (59.5% and 11.9%; P=0.012).DFS and DMFS: ICIs did not result in a significant improvement in DFS (P=0.21) or DMFS (P=0.26). Prognostic Factors: Multivariable analysis identified immunotherapy receipt, clinical stage of esophageal cancer (EC), definitive radiotherapy, and ECOG performance status as independent prognostic factors for OS.Importantly, there were no statistically significant differences in the incidence of grade ≥ 3 neutropenia (P=0.417) or oesophagitis (P=0.37) between the two treatment arms.
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